Key result
Anesthesia method fails to reduce tourniquet-induced hypertension, but shorter duration is linked to lower incidence.
Why the study?
Tourniquet use during limb surgery is associated with severe hemodynamic changes and tourniquet-induced hypertension, but the incidences by tourniquet duration and anesthetic methods are unclear.
RCT (n=113)
Assigned into four groups
No
Prioritizing shorter tourniquet durations over specific anesthesia methods may help mitigate hypertension; leaves open whether any.
Background: A tourniquet is often used during limb surgery to minimize surgical bleeding and to keep the clear surgical field.However the tourniquet is associated with severe hemodynamic changes and tourniquet-induced hypertension.We investigated the incidences of tourniquet-induced hypertension by tourniquet duration and anesthetic methods.Methods: One hundred thirteen patients who underwent a total knee arthroplasty were assigned into four groups according to the types of anesthesia; general anesthesia (group I, n = 30), general anesthesia and intravenous adjuvants (group II, n = 30), general and epidural anesthesia (group III, n = 22), and spinal anesthesia (group IV, n = 31).Mean arterial pressure and heart rate were recorded at ward, before induction, one minute after tourniquet inflation and every 10 minutes until 60 mininutes.The extremity was exsanguinated and a tourniquet pressure of 350 mmHg (9 cm width) was applied in all groups.Results: The mean arterial pressure increased in group I and II during the tourniquet inflation period.The incidence of tourniquet-induced hypertension was higher in group I (6.7%) than other groups but there was no statistical significance among the groups.Heart rates were not changed in any groups. Conclusions:We concluded that the shorter the tourniquet time the less the occurrence of tourniquet-induced hypertension under any type of anesthesia.(Korean J Anesthesiol 2002; 42: 312∼317)
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Cheong et al. (2002) conducted an RCT in Total Knee Arthroplasty (n=113). Four anesthesia methods (general with adjuvants, general + epidural, spinal) vs. General anesthesia alone was evaluated on Incidence of tourniquet-induced hypertension (p=not significant). There was no statistically significant difference in the incidence of tourniquet-induced hypertension among the four anesthesia methods, but shorter tourniquet times were associated with less occurrence of hypertension.
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